Tobacco.Reality.Unfiltered: Using Personal Testimonials to Effectively Communicate Serious Health Consequences of Tobacco Use to Youth In a Major Tobacco Producing State

Theoretical Background and research questions/hypothesis: Well constructed media campaigns are established as effective components of comprehensive youth tobacco prevention programs. Research in controlled lab settings has suggested that ads focusing on long term negative consequences of smoking can be effective approaches to improving youth self efficacy to resist smoking and lowering intentions to smoke. Data from real world evaluations of campaigns using this approach, however, are lacking. Evaluation of the national truth campaign sponsored by Legacy shows that an industry manipulation theme is effective; however, this approach is not desirable or politically feasible in all situations. We examine multiple evaluations of the North Carolina Tobacco.Reality.Unfiltered. social marketing campaign to assess the real world impact of a serious health consequence themed prevention effort.

Methods: The Tobacco.Reality.Unfiltered (TRU) social marketing campaign, supported by the North Carolina Health and Wellness Trust Fund, has been a key component of a statewide, youth-focused tobacco prevention initiative since 2004. This branded, multi-media campaign features ads in testimonial-style format depicting real North Carolinians sharing their stories about the serious health consequences of tobacco use. This presentation will provide outcome evaluation results of six years of the TRU campaign, including data from the 2011 evaluation (currently in the field). Evaluation data come from telephone interviews with a cross section of 1,000 NC youth ages 11 through 17. A dual-frame sample (a mix of random digit dial and a targeted sample) was used to ensure adequate coverage and reduce costs associated with screening households. Current data will be compared to baseline data from multiple years to provide measures of changes over time in primary study outcomes.

Results: We hypothesize that data from the survey currently in the field will show increasing awareness of the campaign among NC youth and that the campaign will continue to be well received by youth, including those youth most at risk for tobacco use.

Conclusions: Multiple evaluations have documented increasing awareness of TRU ads among NC youth and shown that ads are reaching youth at risk for tobacco use. Evidence from these evaluations suggest that testimonial –style ads focusing on the serious health consequences of tobacco use can be an effective piece of a comprehensive tobacco prevention program and that they have contributed to reduced smoking prevalence for NC youth.

Implications for research and/or practice: Our presentation will demonstrate that using true stories of the serious health consequences of tobacco use has been an effective and integral part of a comprehensive youth tobacco prevention effort that has contributed to significant reductions in youth smoking prevalence. We will share some of the ads from the six years of the TRU campaign, discuss other aspects of the comprehensive initiative for campaign context, and explore findings related to campaign awareness and reactions across different groups of youth. This presention will be especially useful for participants working on tobacco control in states where an anti-industry approach is not viable or desirable and participants working on social marketing efforts related to other chronic diseases.